Citation

Muller F, Mühlhauser M, Holze F, Lang UE, Walter M, Liechti ME, Borgwardt S. Front. Psychiatry 2020; 11.

Copyright

(Copyright © 2020, Frontiers Media)

DOI

10.3389/fpsyt.2020.573953

PMID

unavailable

Abstract

A 39-year-old female patient suffering from severe, treatment-resistant depression and other symptoms associated with a complex personality disorder was admitted to our open psychiatric ward for an experimental treatment with lysergic acid diethylamide (LSD). The substance was administered in repeated weekly and ascending doses. Curiously, there were no substantial acute subjective effects of the drug despite adequate dosing, which was also confirmed by plasma drug concentration monitoring. However, the patient showed rapid and significant improvement with most notable changes in depressed mood, emotional instability, loss of energy, and suicidal ideations. Additionally, the SCL-90 questionnaire indicated significant decreases in global severity and in various psychopathological subscales. Improvements persisted for ~7 days after each administration. Due to the severe course of the illness and the resistance to previous treatment it was decided to continue this experimental approach with weekly repeated doses of LSD. The patient will be observed closely with regard to somatic and mental side effects. Two features of this case are remarkable: Firstly, administration of LSD was associated with significant improvements in various symptoms of a condition usually difficult to treat. Secondly, symptom reductions occurred in the absence of acute drug effects. Therefore, the mechanism of action seemed to deviate from the concept that improvements after administration of drugs like LSD are due to experiences during the acute drug effects. This case might indicate that LSD can induce rapid but transient beneficial effects on several psychopathological symptoms. The time course of these improvements resembled antidepressant effects seen after administration of ketamine. © Copyright © 2020 Müller, Mühlhauser, Holze, Lang, Walter, Liechti and Borgwardt.

Language: en

Keywords

adult; human; female; case report; bipolar disorder; treatment; psychotherapy; ketamine; cannabis; suicidal ideation; depression; suicide attempt; lithium; disease severity; intoxication; Asperger syndrome; alcohol consumption; fatigue; mental disease; disease classification; treatment planning; disease association; personality disorder; clinical article; hospital admission; amfebutamone; fluoxetine; mirtazapine; moclobemide; nortriptyline; sertraline; venlafaxine; quetiapine; physical examination; paranoia; disease course; panic; coping behavior; reboxetine; social status; benzodiazepine derivative; trazodone; drug efficacy; olanzapine; risperidone; hospital discharge; lorazepam; psychiatric treatment; valproic acid; relapse; lamotrigine; lysergide; pension; attention deficit disorder; duloxetine; escitalopram; methylphenidate; pregabalin; electrocardiogram; compulsion; low drug dose; modafinil; anhedonia; music therapy; laboratory test; agoraphobia; aripiprazole; atomoxetine; Article; single drug dose; drug dose increase; medical history; treatment duration; visual hallucination; valvular heart disease; repeated drug dose; echocardiography; LSD; cannabis use; vortioxetine; cognitive function test; midomafetamine; hallucinogen